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Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
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Perioperative Inotrope Therapy and Atrial Fibrillation Following Coronary Artery Bypass Graft Surgery: Evidence of a

Jimmy T Efird1,2,3,4,5, Andy C Kiser1,2, Patricia B Crane1,3,4

  • 1Center for Epidemiology and Outcomes Research, East Carolina Heart Institute, Greenville, North Carolina.

Pharmacotherapy
|January 5, 2017
PubMed

Insights

Perioperative inotropic therapy (PINOT) is disproportionately linked to postoperative atrial fibrillation (POAF) in black patients undergoing coronary artery bypass graft (CABG) surgery. This racial disparity warrants further investigation into underlying mechanisms.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Electrophysiology
  • Health Disparities Research

Background:

  • Postoperative atrial fibrillation (POAF) increases mortality after coronary artery bypass graft (CABG) surgery, particularly in Black patients.
  • Perioperative inotropic therapy (PINOT) has been previously associated with POAF.
  • The influence of race on the association between PINOT and POAF remains unclear.

Purpose of the Study:

  • To investigate the relationship between perioperative inotropic therapy (PINOT), race, and the incidence of postoperative atrial fibrillation (POAF) in patients undergoing CABG.
  • To determine if race modifies the association between PINOT and POAF.

Main Methods:

  • Analysis of clinical records from a prospectively maintained cohort of 11,855 patients undergoing primary isolated CABG.
  • Log-binomial regression was used to compute relative risks (RR) and 95% confidence intervals (CIs).

Main Results:

  • The association between PINOT and POAF was significantly higher in Black patients (adjusted RR 1.7, CI 1.4-2.0) compared to White patients (adjusted RR 1.3, CI 1.2-1.4).
  • A statistically significant interaction (p=0.013) indicated that race modifies the PINOT-POAF association.

Conclusions:

  • Perioperative inotropic therapy (PINOT) may be disproportionately associated with postoperative atrial fibrillation (POAF) in Black patients undergoing CABG.
  • Further research is necessary to elucidate the mechanisms behind this observed racial disparity.
Abstract

Keywords:
coronary artery bypass graftinotropepostoperative atrial fibrillationrace

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